Current Issue
Volumes and Issues
For Authors
Manuscript Guidelines
Review Process
Conflict of Interest
Copyright
About the Journal
Editorial Board
Aim and Scope
Policy and Ethical Guidelines
Promotion of the Journal
Print-Version Subscription
Publisher and Contact Information
Contact Information
Sign in as an AUTHOR/REVIEWER
ORIGINAL ARTICLE
RISK FACTORS AFFECTING HEARING IN NEONATAL
INTENSIVE CARE UNIT NEONATES
1
2nd University ENT Department, Attiko University Hospital, Athens, Greece
Publication date: 2016-09-30
Corresponding author
Emmanouil Nisotakis
Emmanouil Nisotakis, 8 Paparigopoulou Str, Agia Paraskevi, Athens, Greece, PO 15343, e-mail: nisotakis@hotmail.com
Emmanouil Nisotakis, 8 Paparigopoulou Str, Agia Paraskevi, Athens, Greece, PO 15343, e-mail: nisotakis@hotmail.com
J Hear Sci 2016;6(3):45-53
KEYWORDS
ABSTRACT
Background:
Neonatal intensive care unit graduates are considered to be of higher risk for hearing impairment, either auditory neuropathy or hearing loss. In this study we examine the presence of risk factors and try to identify their effect on the hearing of high-risk neonates.
Material and Methods:
In this prospective cohort study we used automated auditory brainstem responses (a-ABRs) and otoacoustic emissions (OAEs) to screen 453 neonatal intensive care unit neonates who had at least one risk factor for hearing impairment.
Results:
In the initial examination, 382 (84.3%) infants passed and 71 (15.7%) failed a-ABRs. Out of those who failed, 39 newborns (55%) passed the transiently evoked otoacoustic emission (TEOAE) test, while 32 (45%) failed that test too. Re-examination was performed before their first month of age, eventually resulting in 8 newborns being diagnosed with possible hearing loss and 8 with possible auditory neuropathy. The overall dropout rate was 4.9%. Low birth-weight (p=0.016), as well as craniofacial abnormalities (p=0.03) and TORCH (toxoplasmosis, rubella, cytomegalovirus, herpes) infections proved to have a statistically significant correlation (p=0.05) with hearing impairment.
Conclusions:
Because a significant number of children may have auditory neuropathy, ABRs and OAEs (both transiently evoked and distortion product OAEs) remain the cornerstones of any universal hearing screening program in neonatal intensive care units. An efficient tracking system is needed to reduce the number of neonates lost to follow-up. Low birth-weight, craniofacial deformities, and congenital infections appear to be the most significant factors predisposing an infant to hearing impairment.
Neonatal intensive care unit graduates are considered to be of higher risk for hearing impairment, either auditory neuropathy or hearing loss. In this study we examine the presence of risk factors and try to identify their effect on the hearing of high-risk neonates.
Material and Methods:
In this prospective cohort study we used automated auditory brainstem responses (a-ABRs) and otoacoustic emissions (OAEs) to screen 453 neonatal intensive care unit neonates who had at least one risk factor for hearing impairment.
Results:
In the initial examination, 382 (84.3%) infants passed and 71 (15.7%) failed a-ABRs. Out of those who failed, 39 newborns (55%) passed the transiently evoked otoacoustic emission (TEOAE) test, while 32 (45%) failed that test too. Re-examination was performed before their first month of age, eventually resulting in 8 newborns being diagnosed with possible hearing loss and 8 with possible auditory neuropathy. The overall dropout rate was 4.9%. Low birth-weight (p=0.016), as well as craniofacial abnormalities (p=0.03) and TORCH (toxoplasmosis, rubella, cytomegalovirus, herpes) infections proved to have a statistically significant correlation (p=0.05) with hearing impairment.
Conclusions:
Because a significant number of children may have auditory neuropathy, ABRs and OAEs (both transiently evoked and distortion product OAEs) remain the cornerstones of any universal hearing screening program in neonatal intensive care units. An efficient tracking system is needed to reduce the number of neonates lost to follow-up. Low birth-weight, craniofacial deformities, and congenital infections appear to be the most significant factors predisposing an infant to hearing impairment.
REFERENCES (34)
1.
Norton SJ, Gorga MP, Widen JE, Folsom RC, Sininger Y, ConeWesson B et al. Identification of neonatal hearing impairment: a multicenter investigation. Ear Hear, 2000; 21(5): 348–56.
2.
Nikolopoulos TP. Outcomes and predictors in cochlear implantation. Doctoral Thesis. University of Nottingham, Nottingham, 2000.
3.
American Academy of Pediatrics Joint Committee on Infant Hearing Year 2007 Position Statement. Principles and guidelines for early hearing detection and intervention programs. Pediatrics, 2007; 120(4): 898–921.
4.
American Academy of Pediatrics Joint Committee on Infant Hearing 1994 Position Statement. Pediatrics, 1995; 95(1): 152–56.
5.
Hehar SS, Nikolopoulos TP, Gibbin KP, O’Donoghue GM. Surgery and functional outcomes in deaf children receiving cochlear implants before age 2 years. Arch Otolaryngol Head Neck Surg, 2002; 128(1): 11–14.
6.
Pimperton H, Blythe H, Kreppner J, Mahon M, Peacock JL, Stevenson J et al. The impact of universal newborn hearing screening on long-term literacy outcomes: A prospective cohort study. Arch Dis Child, 2016; 101(1): 9–15.
7.
Starr A, Picton TW, Sininger Y, Hood LJ, Berlin CI. Auditory neuropathy. Brain, 1996; 119(3): 741–53.
8.
Paludetti G, Conti G, Di Nardo W, De Corso E, Rolesi R, Picciotti PM et al. Infant hearing loss: From diagnosis to therapy. Official Report of XXI Conference of Italian Society of Pediatric Otorhinolaryngology. Acta Otorhinolaryngol Ital, 2012; 32(6): 347–70.
9.
ACMG. Genetics Evaluation Guidelines for the Etiologic Diagnosis of Congenital Hearing Loss. Genetic Evaluation of Congenital Hearing Loss Expert Panel. Genet Med, 2002; 4(3): 162–71.
10.
U.S. Preventive Services Task Force. Universal screening for hearing loss in newborns: recommendation statement. Am Fam Physician, 2010; 81(2): 185.
11.
Bielecki I, Horbulewicz A, Wolan T. Prevalence and risk factors for auditory neuropathy spectrum disorder in a screened newborn population at risk for hearing loss. Int J Pediatr Otorhinolaryngol, 2012; 76(11): 1668–70.
12.
Hille ET, van Straaten HI, Verkerk PH. Dutch NICU Neonatal Hearing Screening Working Group. Prevalence and independent risk factors for hearing loss in NICU infants. Acta Paediatr, 2007; 96(8): 1155–58.
13.
Chalkiadakis V, Geramas I, Marangoudakis P, Kandiloros D, Vlastarakos P, Nikolopoulos TP. Neonatal hearing screening in intensive care units. J Hear Sci, 2014; 4(2): 9–16.
14.
Ptok M. Early detection of hearing impairment in newborns and infants. Dtsch Arztebl Int, 2011; 108(25): 426–31.
16.
Nikolopoulos TP, Gibbin KP, Dyar D. Predicting speech perception outcomes following cochlear implantation using Nottingham Children’s Implant Profile (NChIP). Int J Pediatr Otorhinolaryngol, 2004; 68(2): 137–41.
17.
Kemp DT. Stimulated acoustic emissions from within the human auditory system. J Acoust Soc Am, 1978; 64(5): 1386–91.
18.
Mehl AL, Thomson V. Newborn hearing screening: the great omission. Pediatrics, 1998; 101(1): E4.
19.
Erenberg A, Lemons J, Sia C, Trunkel D, Ziring P. Newborn and infant hearing loss: detection and intervention. American Academy of Pediatrics, Task Force on Newborn and Infant Hearing, 1998–1999. Pediatrics, 1999; 103(2): 527–30.
20.
Berlin CI, Hood LJ, Morlet T, Wilensky D, Li L, Mattingly KR et al. Multi-site diagnosis and management of 260 patients with auditory neuropathy/dys-synchrony (auditory neuropathy spectrum disorder). Int J Audiol, 2010; 49(1): 30–43.
21.
Nikolopoulos TP. Neonatal hearing screening: what we have achieved and what needs to be improved. Int J Pediatr Otorhinolaryngol, 2015; 79(5): 635–37.
22.
Horbar JD, Carpenter JH, Badger GJ, Kenny MJ, Soll RF, Morrow KA et al. Mortality and neonatal morbidity among infants 501 to 1500 grams from 2000 to 2009. Pediatrics, 2012; 129(6): 1019–26.
23.
Vohr BR, Widen JE, Cone-Wesson B, Sininger YS, Gorga MP, Folsom RC et al. Identification of neonatal hearing impairment: Characteristics of infants in the neonatal intensive care unit and well-baby nursery. Ear Hear, 2000; 21(5): 373–82.
24.
Bielecki I, Horbulewicz A, Wolan T. Risk factors associated with hearing loss in infants: an analysis of 5282 referred neonates. Int J Pediatr Otorhinolaryngol, 2011; 75(7): 925–30.
25.
Valkama AM, Laitakari KT, Tolonen EU, Vayrynen MR, Vainionpaa LK, Koivisto ME. Prediction of permanent hearing loss in high-risk preterm infants at term age. Eur J Pediatr, 2000; 159(6): 459–64.
26.
Poonual W, Navacharoen N, Kangsanarak J, Namwongprom S. Risk factors for hearing loss in infants under universal hearing screening program in Northern Thailand. J Multidiscip Healthc, 2016; 9: 1–5.
27.
Salvago P, Martines E, Martines F. Prevalence and risk factors for sensorineural hearing loss: Western Sicily overview. Eur Arch Otorhinolaryngol, 2013; 270(12): 3049–56.
28.
Rais-Bahrami K, Majd M, Veszelovszky E, Short BL. Use of furosemide and hearing loss in neonatal intensive care survivors. Am J Perinatol, 2004; 21(6): 329–32.
29.
El-Barbary MN, Ismail RI, Ibrahim AA. Gentamicin extended interval regimen and ototoxicity in neonates. Int J Pediatr Otorhinolaryngol, 2015; 79(8): 1294–98.
30.
Yoshikawa S, Ikeda K, Kudo T, Kobayashi T. The effects of hypoxia, premature birth, infection, ototoxic drugs, circulatory system and congenital disease on neonatal hearing loss. Auris Nasus Larynx, 2004; 31(4): 361–68.
31.
Walker E, McCreery R, Spratford M, Roush P. Children with auditory neuropathy spectrum disorder fitted with hearing aids applying the American Academy of Audiology Pediatric Amplification Guideline: current practice and outcomes. J Am Acad Audiol, 2016; 27(3): 204–18.
32.
Papacharalampous GX, Nikolopoulos TP, Davilis DI, Xenellis IE, Korres SG. Universal newborn hearing screening, a revolutionary diagnosis of deafness: Real benefits and limitations. Eur Arch Otorhinolaryngol, 2011; 268(10): 1399–406.
33.
Korres S, Nikolopoulos TP, Peraki EE, Tsiakou M, Karakitsou M, Apostolopoulos N et al. Outcomes and efficacy of newborn hearing screening: Strengths and weaknesses (success or failure?). Laryngoscope, 2008; 118(7): 1253–56.
34.
Holster IL, Hoeve LJ, Wieringa MH, Willis-Lorrier RM, de Gier HH. Evaluation of hearing loss after failed neonatal hearing screening. J Pediatr, 2009; 155(5): 646–50.
Share
RELATED ARTICLE
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
